Individual
AMANDA J KULESZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
2776 CLEVELAND AVE, FORT MYERS, FL 33901-5864
(239) 343-1614
(239) 343-3695
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-1614
(239) 343-3695
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
018357
NY
363A00000X
Physician Assistant
Primary
PA9116350
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115538600
—
FL
Enumeration date
03/03/2015
Last updated
04/26/2023
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